Dr. Beau Sasser's Sports Medicine Blog

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What's the Rush?

October 25, 2018

“I’m a Hare, I’m a runner, I’m as fast as I can be.
I speed and spurt and whisk along as anyone can see.
I burn out peelin’ wheelies. Even radar can’t catch me.”
~Tortoise and the Hare,
5th grade
play St. Simons Elementary (1981)

My son has one of those Harry Potter wands from Universal Studios. I think
we stood in line for at least 24
hour
to obtain that wand. Of course, it was worth it. Thank goodness for the
roving vendors that slaked our thirst with
butter beer
(cream soda) as we gnawed on turkey legs. Good times. Now, he runs around
the house yelling, “Abracadabra!” and, “Hocus-Pocus!”
followed by, “Daddy, you’re a newt.” I wish I could
take that wand to work. There are many times when I’m sitting in
clinic
, listening to a patient, and at the end of his or her story, the patient
looks at me and says, “Seriously Doc, how are we going to get this
(sprain, strain, fracture, ligament injury) to heal quickly? I got things
to do.” That’s when I want that wand. If only I could say,
“ABRA-
CAPOCUS
!” or, “POCUS-CADABRA!!” You are healed; see you later.

Unfortunately, and yet naturally, healing takes time. Although we can predict
a rough estimate on how long it may take for an injury to heal, there
are certain guidelines that, if followed, can expedite healing. On the
flip side, there are quite a few behaviors by patients that can prolong
the healing process.

Although healing takes time, the ability to heal is influenced by a cast
of other factors that can impact the body’s capacity to heal effectively:

An overworked immune system: The process of healing is complex, utilizing different cell lines and
mediators for tissue healing and repair. If your immune system is impaired
from tackling a cold, or other illness, this could cause a delay in a
proper healing response. Give your immune system an extra boost with dark
green, leafy vegetables and fruit.

Unhealthy choices: Your body is a representation of your overall general health and physical
well being. Correlations have been shown between decreased healing potential
and alcoholism, obesity and smoking.

Sleepless nights: Body tissues need the chance to recover. When we sleep, the brain triggers
necessary
hormones for the repair process. In the athletic population, a minimum
of eight hours sleep can lower the risk of injury. Therefore, increasing
sleep may lead to a faster recovery.

Inactivity: Strict bed rest to recover from injury is a dead concept. Exercise is
a vital part of rehabilitation. As long as movement is comfortable and
pain free
, this can benefit healing by preventing adhesions and aiding in joint mobility.

Stress: Excess stress can have negative health benefits. High levels of stress
can delay healing because hormones released during stressful times can
hinder a proper immune response to injury.

Valuable nutrients: Getting the right nutrients to assist tissue healing and repair is important.
Protein is essential for proper muscle repair. Good sources include animal
protein, fish, eggs
and
Greek yogurt. Oily fish also provide excellent anti-inflammatory properties
as a source of omega-3. Zinc found in nuts, seeds and chicken aids in
tissue growth as well as a good immune booster. Vitamin C aids in tissue
repair and
help
with calcium absorption for cartilage and bone health. High sources of
Vitamin C can be found in tomatoes, peppers, broccoli and citrus fruits.

Now that I have talked about ways to improve overall health to allow the
body the best chance to heal an injury, let’s talk about what to
do in regards to the injury itself. Healing takes time, but it also takes
rest. However, proper rest is trickier and more important than most patients
realize. Many people pay lip service to the importance of rest but ignore
the concept or defy the physician’s advice. Runners are notorious
for this and are invariably the worst offenders for two reasons:

They believe that by resting, they are going to lose their level of fitness
and quickly “go to pot.” First off you will “go to pot” if the injury never heals.
Chronic pain and poor function is a greater threat to fitness than rest.
Secondly, though peak conditioning may be vulnerable, the bulk of fitness
is quite stable
especially
for fit individuals.

Most athletes believe they can exercise their way out of a problem. This is flawed thinking for two reasons. First, long before a tissue fails
under strain it will become “sick” by being unable to match
the strain with proper maintenance and repair. Secondly, the injured site
loses its ability to tolerate even minor stresses, so activities that
use to be fine (light jogs) become a problem. Therefore rest is critical
to stop challenging the injured site, or it will never have a chance to recover.

The art of rest is by adhering to
Relative Rest. Think of the injured site as the weak link in the chain and focus on
other exercises or activities that provide fitness without stressing the
injured site. I tell my patients that instead of focusing on the negative
that they are not able to perform their normal exercise regimen, look
at an injury as a good time to branch out. During this time of rest and
rehab is the perfect time to try something new:

Hurt shoulder or elbow playing golf? Get some lessons to work on the short
game. Find a trainer and focus on lower body and core.

Swimming is one of the most classic options for relative risk.

Yoga. I have discussed in the past how yoga is great for improving joint
flexibility and overall strength.

Walking is a surprisingly good and non-stressful exercise.

Find a trainer and learn a new workout in the gym.

Knee or hip injury? Try kayaking or Stand Up Paddleboarding.

These are just a few ideas, but the concept is the same. Think outside
of the box to find something new while your body heals, and the time will
roll by. How long is long enough? That is truly the $64,000 dollar question.
I agree with most physicians that patients need to rest until the injury
feels better. Then they can
SLLOOOWLLY get back into their regular activity starting around 25 percent of their
normal pre-injury level and work back up to their full workout routine
over four to six weeks.

As I tell my kids, “Go outside and find something to do.”

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